Felicia Newell, RD, MSc
There are a lot of myths out there about what people with diabetes “can” and “can’t” have.
For the purposes of this post, we will be talking about Type 2 Diabetes, since it is the most common form, and can typically be treated or managed with diet and lifestyle changes.
Adopting a healthier lifestyle and managing blood glucose levels can help prevent or control type 2 diabetes, and can significantly reduce complications such as heart disease, stroke, kidney disease, etc.
The health and wellness world can be a confusing one, especially for people with diabetes or other health conditions.
Most of the foods that people with diabetes are told that they can’t have are for similar reasons – because they contain carbohydrates, which are the sugars, starches and fibre found in fruits, grains, vegetables and milk products (except fibre doesn’t impact blood sugar, so it doesn’t technically count).
I will lump together some of the most common ones I hear (and that other dietitians I have consulted with hear as well).
Diabetes ‘Can’t Have’ Myths:
· All Carbs – e.g., oats, potato, sweet potato, cereal, milk, fruit, rice, quinoa, pasta, etc. · “Anything White” – potatoes, white bread, milk, pasta, sugar · Fruit · Cake and Other Desserts (not even as once in awhile treats such as a birthday or special occasion) · Sweet, or Starchy Vegetables – e.g., corn, peas, carrots or squash (because they contain carbs, and/or because people assume that because they are sweet they are high in ‘sugar’)
I should start by saying, I am ALL about everyone choosing a well-balanced diet, with as many whole foods and the least amount of processed foods as possible. Check out the ‘Mediterranean Diet’ here and here for an example on what I believe we should strive for with a healthy diet.
However, I am also a health professional who recognizes the ‘Social Determinants of Health’ and the ‘ecological aspects of food’ – which in basic terms means, there are MANY factors that influence why people do what they do, and in turn, their health.
Just some of these factors include: income and social status; social support networks; education; employment and working conditions; physical environments; mental health and coping skills; past experiences; culture; access to food; food systems; etc.
Reasons Why the Above Restrictions Are Myths:
1) Many of these foods also contain valuable nutrients such as fibre, vitamins and minerals, and all CAN be part of a ‘all foods fit’ healthy diet for those with diabetes, by following the strategies in number 3.
2) It would be extremely difficult and unsustainable to cut out ALL of these foods for the majority of people. Until our complete environments support every single person to adopt a lifestyle where they eat perfect all of the time, it’s not doing the public any favours to expect everyone to. That is why many health professionals adopt the ‘80/20’ rule to eating. On top of this, people with diabetes have enough to face. Diabetes requires individuals to balance multiple self-care behaviours, problem solving, home monitoring and medical follow-up appointments while facing the uncertainty of future complications. In this context it is not surprising that psychological issues such as depression, anxiety and eating disorders have been identified in people with diabetes.
3) There are many factors that affect how meal or snack impacts the glycemic response (aka how food impacts the blood sugar) in an individual.
Here are some actionable strategies for managing blood sugars, while still enjoying a balanced diet where ‘all foods fit’. See more tips here.
Incorporate foods high in protein, fibre, and fats into each meal and snack, as these nutrients slow down the digestion of food. This helps to regulate blood sugar and prevent a spike after a meal. These nutrients also help you feel full for longer, which helps prevent unnecessary snacking in between meals.
Here are just some examples of:
Healthy sources of protein: lean meats, fish, eggs, dairy, beans, peas, lentils, nuts and nut butters, seeds, tofu, plain Greek yogurt, etc.
Healthy sources of fibre: oats, whole grains, lentils, beans, peas, brown rice, vegetables and fruits.
Healthy sources of fats: eggs, avocado, nuts and nut butters, seeds, and vegetable oils.
Eat three meals per day at regular times and space meals no more than six hours apart. (Some people benefit from a healthy snack, but that is dependent on the individual).
Keep carbohydrate consistent at each meal (this amount is different for each individual).
Drinking water to quench thirst instead of juice, soft drinks, energy drinks, etc. (Coffee and tea are usually fine, with small amounts of milk or cream).
Incorporate physical activity into your life, which can help improve blood sugar control.
A modest weight loss of even 5-10% can help with better blood sugar regulation.
Practice mindful eating, which includes: tuning into our body’s natural physiological ability to recognize hunger and fullness; asking ourselves if we are eating because we are actually hungry, or for another reason (emotion, stress, boredom); not judging ourselves or others’ food choices. More on mindful eating here.
Follow the ‘plate method’ and portion guide for balanced meals, to help with blood sugar regulation, portion sizes, getting adequate nutrients, and feeling ‘full and satisfied’.
Monitor blood glucose levels in a way that is agreed upon with your healthcare provider(s).
If you’re someone who finds it difficult to eat ‘treat’ foods in moderation, or to follow any of these tips or strategies, then it is important to work with a health professional to get help with setting and achieving goals, and in developing a healthier relationship with food with strategies that work for you.
Again, each and every person is different, and, diabetes can be a stressful and confusing disease that is why working with a team of health professionals such as a dietitian, diabetes educator, and doctor is important, to work on a nutrition and lifestyle plan that works for you and your life.